Do Therapists Tell Clients What To Do? Advice, Consultation And Problem Solving

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It is not uncommon for therapists during an in office session for a client to say; “I know you cannot tell me what to do but . . .”. Do talk therapists tell clients what to do during counseling sessions? From time to time I am asked about the role of a therapist in terms of giving guidance. There are those that are considering seeking out therapy but wonder; how can therapy help, if a therapist does not tell a client directly what to do? Guidance, advice, consultation, direction – what do you think? Are they one in the same?

Options

When a client asks me for my advice AKA what to do, do I tell them what to do? Advice, guidance, consultation is not necessarily one in the same as telling a client “what to do”.  The answer is; I explore with them what they think their options are. I also offer concrete options. With the client, we explore together the various options available to the client so that they can ultimately decide what to do. In this way a menu list variety is available for the client to explore and consider. Some options make sense for the client, some options are a stretch, some are a better fit,  . . . but options indeed. I provide concrete strategies, techniques, and exercises to help them determine the answer to their questions so that they can achieve their therapeutic goals.

Insight/Advice

Providing clients with therapeutic insight, theory, rationale, therapeutic education, facts, concerns, options, direction opinion options with theories of why . . . and discuss these very pieces; this all helps the client to help them-self to answer their own question.

A common challenge that clients come in for advice includes; relationship challenges. As a therapist who specializes in relationship issues, there includes a variety of relationship struggles that clients require consultation about. Relationship struggles include; marital, divorce, parent – child, siblings, adult parent – child, in-laws, employee – boss, colleagues, etc.

The type of advice as a therapist I provide are concepts to consider. Specifically, important philosophies to chew on. Then ultimately for the client to make their own decision. For an example, I say things like; “the choices you make today will impact your relationship future with this person, so choose wisely.” Further questions I may ask a client to help them to evaluate their decision options and determine the answer to their question includes; “How might this choice vs. this choice impact you and those you love short term and long term?” Also, I say things like; “what do you want to do vs. what do you think you should do?” I explore with the client; “What is the right thing to do? Do you want to do the right thing? Why or why not? Will you do it anyway?”

Clients often have a support network of those they tend to ask advice from. Some clients follow the advice of their confidants, others use it as information but their pattern is not necessarily to follow the advice of others. I ask who their main network is, whether they typically seek out the advice of others and follow it, or not. Thus, another question explored is; “What is the opinion of those in your immediate circle? Does their voice matter in your decision?” I always explore with the client which of their choices is the mentally healthy option.

It is statements and questions along the lines of the aforementioned that help clients to self introspect, gain increased awareness and insight into their opinion thereby discovering their own answers to their questions.

Help Clients To Help Themselves

Helping clients to help themselves find options, evaluate choices, self introspect, and make their own thought felt decisions helps clients to feel empowered so they not only make decisions about what the current presenting challenge is. This therapeutic methodology also helps people to feel grounded in how to figure out how to and make decisions about other situations that arise during their life throughout their life journey. It is this metal health and wellness expert’s opinion that it is a therapist’s job to help empower clients and help them to help themselves self discover, find answers, make their own decisions, and take action on those very discoveries.

Consultant

A therapist acts as a consultant. As a consultant you explore with your client the various options and scenarios that may play out based on the various roads the client considers traveling. For an example, an adult client may share with their therapist that their mother is toxic and they are considering cutting ties with her. “I know you can’t tell me what to do, but . . . ” says the client. Or, a couple may share that the mother-in-law is a bad influence on their children and they are considering not inviting her to future family functions. The therapist who is mindful of helping clients to help themselves find the answers within would say something like; “You are right, I am not going to tell you what to do because it is your decision to make. Rather let’s consider and discuss your thoughts and feelings, how you got to this emotional place, and let’s explore the potential scenario outcomes that may or may not occur if you were to go down the path you are considering. Furthermore, let’s explore several different paths and what you think and feel about each one and why.” It is this process that empowers clients and helps them to help themselves make decisions in the now and in the future.

Finding one’s inner voice, being mindful of choices and how those choices impacts self and others, determining what choice to make and feeling confident in one’s inner voice is a significant part of the role of a therapist to help clients to possess. This all of course is in my humble opinion as a talk therapist for 20 years. I am solution focused in my work and a significant part of finding solutions that fit for the client, that work for the client, is being mindful of what their goals really are and helping them to help themselves access the solution towards achievement and success of their goals.

Finding Answers Within

It is the very process of talk therapy that allows clients to realize that they have their own answers within. They are not perfect, they will make mistakes along the way, but it is their mistakes to make. The process of self discovery of one’s thoughts, feelings, opinions, fears, worries, joys, pains, concerns, desires . . . – confronting of self and who one was, is, and wants to be in the key relationships in their life is a powerful process and a life long journey.

There is a big difference between a therapist telling their client; “your adult parent is toxic stay away” or, “your spouse stinks, so leave” or, “dump your boyfriend he’s not good for you”, versus the approach of discussing with the client their feelings, their opinions and their options. Exploring with the client what they feel and how their choices may impact them and those they love now and in the future is how to help them to help themselves make decisions. That is how many therapists in the office typically advise rather than the former.

Tips/Ideas

As a solution focused therapist who is direct and tells clients like it is, I provide concrete strategies, tips, ideas, exercises, and techniques for clients to implement to help them reach their goal. Whatever their goal may be. I call clients out if they are swaying from their goal intent, in a compassionate manner. Ultimately though, it is only in the client’s control, not the therapist’s control, for what choices the client makes once they walk out of the therapist’s office. For an example, if your goal is to help your spouse feel appreciated and valued, a technique is to initiate something fun to do that they enjoy, so they feel special. Direct concrete communication of your appreciation of that person is another strategy. Another tool is to show with your body language with hugs and other physical interactions. Another technique is to be mindful of doing something nice each day for the spouse. Helping the client understand these concepts, we then further discuss and explore what examples the client comes up with to apply this theory. Then as the therapist you explore if the tips you offered is helpful “advice”. At the next session, it is important for the therapist to check in with the client as to what they did versus did not implement and what the results were. There is quite a range as to how hard clients work mentally, emotionally, and/or taking action each day implementing the tips and ideas discussed between sessions. What they experienced and felt during the week of considering implementing the tips or implementing the tips are explored. By following up in each session as to what happened between appointments,  it helps the client to evaluate themselves and their experience. It is the understanding of one’s self that ultimately helps a person in their everyday relational interactions and personal decisions.

Do This Don’t Do That

So, the question is; does a therapist ever say; “do this don’t do that?” Certainly I would not speak on behalf of any therapist therapist other than myself. Although, I can speak in generalities from therapist report and state that typically for most therapists they do not say; “do this don’t do that.”. In certain circumstances (e.g., safety) a bold statement is warranted- not in those words, exactly, but direct non the less is required. Okay, likely anyone who is reading this recognizes that when it comes to safety there is a different set of “rules” in therapy so to speak. That is not the focus of today’s blog.

Which leads us to the question; what if it is not about safety per-say? But rather the life choice a client is making is hurting their or their loved one’s mental wellness? Does a therapist say; “do this don’t do that?” Do know that even with the bold statement of what I offer to do it is never; “do this don’t do that” as decisions are always for the client to make. I will state my opinion concretely if I believe their choice is hurting themselves or another.

In addition, I may say something along the following lines; “The style of which you are choosing to interact with your children is not the philosophy that I educate my clients to implement. There are options, more therapeutic and do-able options. Tools I am happy to share with you that will help you and your children feel good, improve the relationship and result in a happy and healthy child and adult.” I then of course provide the clear options. Another example of what I may say to help a client rather than  saying; “do this don’t do that” is;  ”Ultimately you do need to make your own decision about this person you are dating. I am concerned about you and it is clear that the decision you are making is hurting your mental wellness. My goal, my desire, is to help you to help yourself get to a better place. So, it is not for me to tell you what to do or not to do. You do know that this relationship is unhealthy. Do you? The question is; if you know the relationship you are in is unhealthy, and you continue to share with me that you are unhappy in this relationship, why do you think you are making the choice to remain? Let’s explore. You don’t have to feel pressured that you need to decide if you want to continue to date this person or not date this person. Let’s simply take our time and explore.”

If This Then That

When a client is in need of advice, in need of guidance/direction that is concrete in order to make a specific decision about something, ‘If this then that’ is the method I like to use. When it is clear to me as a therapist that time is of the essence either literal and/or emotional, to help the client to help themselves to make a decision ‘If this then that’ is what I find helps the client.

Imagine any given scenario you are struggling with making a decision about right now. It could be about parenting, marriage, the list is endless. For example, it could even be about you and your relationship with your job (e.g., you have been offered 2 jobs which should you take is the question). Use this technique to help yourself make your decision. As a therapist I explore right then and there with the client “If this  ____________ then that ____________”. For an example, if you take this job then that will occur; specifically asking what the that is to the client means; what will your experience likely to be. Does the “then that” meet the needs you have (e.g., hours, benefits). Versus, “If you take this job, then ___________ (what will your life look like). The ‘If this then that’ concept helps the client gain clarity.

Sometimes, the client needs help with what the then ______ may look like. At that point I find it beneficial to provide the client with concrete likely ‘then’ scenarios to help them evaluate what is the better ‘then’ fit for them. Again, ultimately the client is making the decision. As the therapist you are offering the client the tool to make their decision. The wisdom as an experienced therapist and knowledge of the particular client helps create ‘then’ scenarios to communicate to the client and with the client, as well as the client’s ‘then’ scenario input. Which ultimately leads to the client deciding what to do.

Talk Therapy

If you are considering talk therapy and are interested in understanding if therapists are known not to give advice, then how does therapy help if they are consultants – I am hopeful this blog helped begin the conversation in your mind of answering that very question of what therapy can do for you.

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Follow Dr. Karen on Twitter or Facebook. Media Psychotherapist Guest Expert; Relationships, Parenting, Human Behavior, Analyzes Hot Topics In The News. Has appeared on FOX News Channel's: The O'Reilly Factor, FOX & Friends, FOX & Friends FIRST, America Live, Hannity, America's Newsroom, and FOX Business Network's: Cavuto. Go–to for FOX News Boston including the regular segment; Ask Dr. Karen. Also appeared on ABC's Good Morning America, Discovery Network's Destination America, The Steve Harvey TV Show, and more. Sought after Radio Guest Expert. Columnist. Often quoted in various print media: FOX Business, FOX News Magazine, Boston Globe, Boston Herald, Care.com, Good Housekeeping, Yahoo Shine, Parents, Parenting, CNN, TIME, Woman's Day, Men's Health, USA Today, and more. Owner/Founder/President: Dr. Karen Ruskin & Associates, Inc. Based in Massachusetts. Author of: 9 Key Techniques For Raising Respectful Children and Dr. Karen's Marriage Manual. Copyright 2012.

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